超细支气管镜联合EBUS-GS对周围型肺癌诊断效能及影响因素分析

Analysis of diagnostic efficacy and influencing factors of ultrathin bronchoscopy combined with EBUS-GS in peripheral lung carcinoma

目的探讨超细支气管镜联合带引导鞘的支气管内超声(EBUS-GS)对周围型肺癌的诊断价值。方法纳入2015年8月至2016年6月就诊唐都医院呼吸科的高度疑似周围型肺癌患者208例(0.8 cm<直径<4 cm),超细支气管镜联合EBUS-GS活检,进行良恶性病变诊断率的比较,不同影响因素下诊断率的比较及诊断效能的评价。结果 208例患者中确诊肺癌180例,EBUS-GS对肺周围型恶性病变诊断率高于良性病变,有统计学差异(χ2=3.884,P=0.049);病变距肺门距离≤4 cm、≤5 cm和≤6 cm的诊断率分别为88.158%、74.545%、55.102%,三组间卡方检验(χ2=17.371,P=0.000),有统计学差异;有支气管充气征组与无支气管充气征组诊断率分别为84.906%、70.866%,两组间卡方检验(χ2=3.931,P=0.047),有统计学差异;超细支气管镜联合EBUS-GS对周围型肺癌诊断敏感性75.000%,特异性92.857%,约登指数0.679。结论超细支气管镜联合EBUS-GS对周围型肺癌的诊断效能高,安全可靠。

Objective To evaluate the diagnostic value of uhrathin bronchoscopy and intrabronchial uhrasonography（EBUS-GS） combined with guide sheath in peripheral lung carcinoma. Methods 208 cases of suspected peripheral lung cancer（0.8 em〈diameter〈4 cm）were treated with uhrathin bronchoscopy combined with EBUS-GS biopsy from August 2015 to June 2016. The diagnostic rate of benign and malignant lesions were Comparison of different diagnostic factors and the diagnostic efficiency of the evaluation, Results One hundred and eighty cases of malignant tumors were diagnosed in 208 cases. The diagnostic rates of EBUS-GS in the pulmonary malignant lesions were higher than that in the benign lesions. There were significant differences（ X2= 3.884, P=0.049）. The diagnostic rates of the lesions from the hilum distanee≤4 cm, ≤5 cm ands〈6 cm were 88.158%, 74.545% and 55.102% respectively, there were significant differences （X2= 17.371, P = 0.0（30）. The diagnostic rates of bronchial aerated group and non-bronchial aerated group were 84. 906%, 70. 866% respectively, there were significant differences （ X2 = 3.93, P = 0.047）. The sensitivity of uhrathin bronehoscopy combined with EBUS-GS in the diagnosis of peripheral lung carcinoma was 75.000%, specificity was 92.857% and the index was 0.679. Conclusions Uhrathin bronehoscopy combined with EBUS-GS is a safe and reliable method for diagnosis of peripheral lung carcinoma.